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Organization
LAS CRUCES DENTAL SOLUTIONS LLC
Active
Organization
LAS CRUCES DENTAL SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATHEW CHARLES PETERSEN DDS (MANAGING MEMBER)
(575) 527-4746
Entity
Organization
Contact information
Practice address
2001 E LOHMAN AVE STE 121, LAS CRUCES, NM 88001-3195
(575) 527-4746
(575) 904-7152
Mailing address
2001 E LOHMAN AVE STE 121, LAS CRUCES, NM 88001-3195
(575) 527-4746
(575) 904-7152
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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